Australia’s approach to treating children with gender confusion has stifled free speech and punished doctors like Jillian Spencer for expressing their professional opinions.

But as the debate surrounding medical and psychological care for gender questioning children and young adults intensifies, a new study has put pressure on Australian health providers to demonstrate that their approach is based on evidence. The study provides further evidence about the harmful nature of the treatments and the politicisation of the results.

The study, authored by an international team of authors and led by Australian clinicians, highlights the potential “serious human cost” of unresolved tensions in medicine, politics, and culture over treatments being provided to gender confused youth. It highlights a growing divide internationally between  “gender affirmation” approaches to treatment and a shift towards evidence-based safeguards in nations like Sweden, Finland, and the UK. These countries are increasingly scrutinising the efficacy and safety of puberty blockers,  which nevertheless remain foundational to Australia’s approach.

“The paper … challenges the idea that Australia’s children’s hospitals differ markedly from the Tavistock Clinic in London, whose practices triggered the UK Cass Review that led to a total windback of the medicalised pathway of care. That is contrary to the arguments of many in Australia’s health sector who seek to differentiate Australia’s approach from the Tavistock”.

The study documents the “split that has emerged internationally between [an] approach to gender medicine that emphasises self-determination, identity and body autonomy, depathologisation, and elimination of discrimination, versus ‘the rise of evidence-based medicine’ and the reintroduction of guidelines centring on patient safety.”

The study’s claim is strongly disputed by Australian gender clinics.

A crucial point raised by the study is the absence of comprehensive long-term outcome data on these treatments. While Australian health systems insist they are providing multidisciplinary care, which is intended to mitigate risks, the lack of robust, conclusive data raises questions about the long-term safety and effectiveness of hormone treatments in children.

Leading the charge by Australian practitioners is child and adolescent psychiatrist and HRLA client Dr Jillian Spencer, who is calling for the Royal Children’s Hospital Gender Service to publish its interim outcome data. Dr Spencer said:

“The study has been running since 2017 collecting long-term follow-up data and has published four papers reporting baseline data, but no comprehensive data on outcomes”.

It is clear that Dr Spencer’s approach aligns with a growing medical consensus that promotes a cautious approach to treating minors with gender dysphoria, reflecting investigations and policy shifts in Finland, Sweden, and the Netherlands, as well as recommendations from the Cass Review in the UK.

Despite this growing body of evidence, Dr Spencer’s employer, the Queensland Children’s Hospital, is not allowing a cautious approach. She has filed a complaint with Queensland’s Human Rights Commission, asserting her right to oppose the hospital’s “affirmation” model, which she views as lacking scientific support.

HRLA is proud to represent Dr Spencer as she challenges the policies of the hospital which require her to use preferred pronouns and names and document all records based on a patient’s chosen gender identity. She will be arguing that enforcing a gender-affirmation model conflicts with her human rights, specifically her rights to freedom of thought, conscience and belief, and to express her opinions freely.